Program

Here are the sessions we have accepted for October 2020. This isn’t a schedule, is unedited, and may change if presenters drop out; but this will give you an idea of what’s in store for this year’s conference. A full schedule will be available in the coming weeks.

Note: for expediency, only one presenter is shown for each. No disrespect intended to the other presenters, who will be visible in later versions.

Humans Touch: Doctors, Patients and An Artful Approach to Co-Healing

(Day-long pre-conference workshop)

Corresponding presenter: Cyraina Johnson-Roullier BSJ, MA#!1, MA#2, Phd University of Notre Dame Chicago, Illinois

This workshop seeks to explore and alter common perceptions of healing. Traditionally, a person who is ill seeks the services of a doctor, and together they assume the roles of “patient” and “provider.” Patients expect doctors to heal them, providers expect to offer care to the best of their knowledge and ability. But in today’s medical environment, the expectations introduced by this arrangement are often not met. When this happens, the interaction between doctor and patient goes unfulfilled. Patients are often disappointed with the care they receive, doctors begin to lose their own sense of health and well-being as they try to meet the ever-increasing need for care. Much has been written about the ways in which the U.S. healthcare system is broken, but aside from a major overhaul,, what can be done to alleviate the suffering caused by this problem? This workshop will investigate the multiple properties of touch as an aid to healing not just for patients, but for doctors, and anyone. Through sensory and conversational exercises the workshop takes participants into a multiverse where they co-create healing spaces. Participants will investigate the dimensions of human touch both physical and extra-physical, to better understand the process of co-healing, doctor to patient, patient to doctor, self to self—human to human. Humans touch.

Transforming Life into Art: A workshop for prose writers

(Day-long pre-conference workshop)

Corresponding presenter: Carol Scott-Conner MD PhD University of Iowa Carver College of Medicine Iowa City, IA

Our daily lives are rich in poignant, revealing, even humorous events – experiences – worth sharing with a wider audience. But how do you transform these into a short story or a piece of creative nonfiction? This workshop will help you take an experience, idea, or anecdote and frame it as a story for possible publication. We will discuss problems confronted by all clinician-writers (such as confidentiality) as well as your own specific concerns. Illustrative material from published clinician-writers and writers of pathographies will be supplied as examples. Be prepared to roll up your sleeves and write in a supportive environment.

Renewal Through Narrative: A Storytelling Workshop

(Day-long pre-conference workshop)

Corresponding presenter: Sheri Reda MA, Modern Letters; MAR, Religions and the Arts; MLIS, Community Informatics Flow and Moment, LLC; Advocate Healthcare Narrative Medicine Committee Chicago, IL

Feeling depleted, exhausted, alienated, cynical? According to the World Health Organization (WHO), these symptoms point to occupational burnout. The AMA asserts that almost half off all physicians experience burnout at some time in their careers. Occupational burnout is characterized by decreased efficacy and satisfaction. But when it is addressed, both efficacy and satisfaction return. Personal narrative is an effective way to address the inherent stressors of a medical career. Instead of riding inside a negative loop, writing and storytelling allow practitioners to create a narrative so that meaning can emerge from experience. This workshop offers experiential instruction in the practice of building scenes around images, reactions, and experiences. It also makes use of tools for close reading and exegesis in order to allow insight to unfold. Presentation tips will also be addressed.

Who wrote this poem?

(Discussion session)

Corresponding presenter: Greg Mahr MD Wayne State University, Henry Ford Hospital Northville, MI

The author wrote the poem, of course. But that’s the easy answer. Poets and writers will commonly say that they don’t do the writing, they just hold the pen. Dr. Mahr, a psychiatrist and psychotherapist, will discuss this phenomenon from the point of view of dissociation, which is frequently viewed pathologically. Indeed dissociation is associated with disorders like PTSD and borderline personality. Yet the capacity to enter into dissociative states may be a hallmark of creativity. The great Portuguese poet Fernando Pessoa wrote his most important works as identities which he called “heteronyms.” Pessoa became a great poet only after the first of them appeared. One of the coauthors of this paper, David Watts, a highly respected poet, writes some of his best work as a distinct entity, “harvey ellis.” Watts states that “although the feeling of dissociation exists with me in the in the state in which I write the ellis poems, what I’m doing is transcending the demands of consciousness for what travels underneath. There lies the more spontaneous, quirky, wild and irreverent material that pushes language into something new. That region follows a logic not of daytime thinking but of the emotional currents of the underbelly where there is a different way of understanding what is real – not reasoned, but felt.” Part of this presentation will include an unscripted dialogue between the psychiatrist/psychotherapist and the poet ellis. Through this dialogue we may be able to gain a sense of who ellis is and how he came to be.

“Going Viral”: Leveraging your own Communication Skills at the Crossroads of Medicine and the Media

(Discussion session)

Corresponding presenter: Sarah Ash Combs MD Children’s National Hospital Washington, DC

Tweet. Like. Post. Repeat. At a time when physician visits are often limited to 15-minute windows, our patients have open access and seemingly infinite time to trawl online resources, gathering their medical advice from blogs, video clips and social media threads. In this climate, it is important for healthcare providers to engage with outlets that enable us to extend our voice and advice beyond the four-walled brick-and-mortar confines of our clinics and hospitals. This session will be highly interactive. We will open with a brief discussion of how popular media influences the public’s perceptions of, and decisions within, the healthcare realm. Together, we will critique select medical news stories. Then, based on my own experience working closely with my hospital’s PR team in the medical journalism field, I will present techniques for approaching media interviews (on-camera; live; pre-recorded; radio) and crafting blog posts. We will then break out into a small group workshop format in which participants will use these techniques to formulate their own key message(s) on a topical medical issue. Coming back together, each group will present their topic to the room in a simulated live interview format.

Global Health Parallel Charting

(Discussion session)

Corresponding presenter: Theodor Uzamere MD, MHS Baylor College of Medicine/Texas Children’s Hospital Houston, Texas

Leaders in residency global health education acknowledge the importance of reflective debriefing for trainees upon their return from rotations in low- and middle-income countries (LMIC). There are not yet any widely agreed-upon methods for providing such opportunities. Narrative medicine includes a pedagogy of skills for facilitating reflection on clinical experiences. One such skill is “parallel charting:” a written reflection of how a patient’s story intersects with a clinician’s story and subsequently impacts the care provided. A small group reading and discussion of that piece then takes place in an appropriate setting. In our curriculum, pediatric faculty, experienced in narrative medicine, teamed with global health education leadership at a large pediatric residency training program to offer a structured debrief opportunity utilizing parallel charting following rotations in LMIC. Debriefs included at least one narrative medicine faculty facilitator and one to four pediatric residents. Residents overwhelmingly found the structured debrief to be a positive experience and expressed interest in additional opportunities to reflect on their clinical experiences. Structured debriefing based on parallel charting is feasible, and fills a known deficit in residency global health education. Opportunities to expand this project include thematic analysis of experiences residents find most impactful. Challenges include scheduling cohorts of residents upon return from global health electives. This session focuses on the experiences of both faculty and residents in designing and participating in the curriculum, with audience participation and discussion about using reflective writing strategies in global health education.

Patient-Physician Communication: A MedHumChat Discussion

(Discussion session)

Corresponding presenter: Jennifer Caputo-Seidler MD University of South Florida Tampa, FL

A live audience version of MedHumChat (short for Medical Humanities Chat). MedHumChat’s mission is to foster reflection, empathy, and connection in healthcare through engagement with the arts and humanities. The cornerstone of MedHumChat is our Twitter chats. The first and third Wednesdays of each month at 9pm EST we gather on Twitter under the hashtag #MedHumChat and discuss two works (poems, short stories, essays, paintings) on a shared theme. In this session we will discuss two pieces on the theme of physician-patient communication using the poem What the Doctor Said by Raymond Carter and an excerpt from the memoir Left Boob Gone Rogue by Uzma Yunas. Active audience participation is encouraged. Additional questions and comments will be sourced from the corresponding live Twitter chat.

Movies that Matter

(Discussion session)

Corresponding presenter: Lindsey Nicholls PhD University of Essex Colchester, Essex

Feature length commercial films (movies) can provide health care students with emotionally nuanced and ethically complex narratives (Saldaña, 2009) These can be used in education for discussions on many relevant clinical and/or professional issues; e.g. depression and/or disability, gender stereotyping, professional reasoning and the importance of understanding context (e.g. social, political, historical, environment). This discussion session will use a film, ‘the Sea Inside’ (2004) directed by Alejandro Fernando Amenábar Cantos, to consider if it can enhance health science students’ critical reflection and ethical reflexivity on caring for a person with a spinal cord injury who wishes to end his life. As Mackey (2007) described, ethical reflexivity may require the student to see themselves as (or in) the other. Following the immersive watching of this film, the educator asks students; which of the ‘carers’ they identified with the most, and why they think that is. The session will use examples from the film and encourage the writing of reflective accounts to share with each other. These steps reflect the pedagogic process that can be used in learning with film; from promoting critical reflection through the use of focused questions (prior to the film being shown) to the use of ‘blogging’ for small seminar groups that encourage the exchange of, and response to, each other’s personal reflections. The discussion will explore the use of film narratives as an evocative educational medium and the use of reflection through writing and peer feedback to develop insights into the personal processes behind professional reasoning.

The Otherness of Fat: An Intersectional Psychotherapy Story

(Discussion session)

Corresponding presenter: Hilary Offman MD FRCPC University of Toronto Toronto, Ontario

Intersectionality refers to the insight that the organization of power is shaped, not by a single axis of social division, but by many social determinants that influence each other. While physicians commonly encounter these determinants in clinical work, modern medical practices have not sufficiently addressed how they impact the treatment of the body in everyday life. Even when viewed through the lens of narrative medicine, stories of illness can be one-sided and neglect an exploration of how discrepancies in culture, power, and privilege between doctor and patient intersect to affect health. We need narratives that include not only stories about treating diverse medical bodies, but also an exploration of how being different impacts that treatment. To truly facilitate understanding the subjectivity of our patients, we need to tell stories that also introduce us to the self-reflection of treating physicians. A psychotherapy story that includes details of a psychiatrist’s participation in the creation of her patient’s health narrative can serve to bridge the gap between humanities and health. For many patients, disparaging assumptions about body size interfere with the pursuit of health care. Furthermore, body size intersects significantly with gender since fat women are subject to specific forms of bias and discrimination not experienced by (those perceived as) fat men. This presentation consists of a nonfiction medical story about what happened when the stigma of being a fat female physician introduced intersectional shame into the treatment of a fat female patient.

Communicating Well In Medicine: Connecting Our Cognition, Values, and Philosophy

(Discussion session)

Corresponding presenter: John Schneider MD, MA, FACS Washington University School of Medicine St. Louis, MO

“The single biggest problem in communication is the illusion that it has taken place.” – George Bernard Shaw. Clinicians devote our entire careers to developing powerful and exact clinical decision making. In practice we acquire much of the important information needed for those decisions through our conversations with our patients and colleagues. We are taught to attend to both the scientific and humanistic choices in medicine, and in those conversations have the opportunity to learn about the philosophy and values of our colleagues and patients. But as our cognitive energy is dedicated to increasingly complex clinical and administrative information management, we rely heavily on cognitive shortcuts to think and speak more quickly. These shortcuts often facilitate our information management but can also hinder our ability to connect with peers and patients, convey meaningful information, or listen with the intent to understand. We have put significant effort into protocolizing communication in medicine through checklists and rigid formulas, which helps us manage increasing cognitive demands. But by focusing on following protocol, we can miss opportunities for understanding deeper humanistic questions, leaving patients and clinicians with unresolved ethical and philosophical conflict. Those questions can impact the quality of care if the patient and care team cannot communicate about those deeper philosophical issues. Through the lens of metacognition, we will discuss how to improve our humanistic communication in health care while meeting the demands of high quality decision making.

Teaching Advocacy Through Narrative Medicine

(Discussion session)

Corresponding presenter: Gwen Erkonen MD, MME Baylor College of Medicine Houston, TX

Understanding the social determinants of health and advocating for change is crucial to providing appropriate care to all populations. Pediatric patients are frequently the first victims of social injustice. Hence the ACGME now requires advocacy training in pediatric graduate education. To address this need, Baylor College of Medicine developed a special track within its pediatric residency to teach and promote advocacy: the LEAD program. At the request of the program directors, we utilized narrative medicine principles to build this novel curriculum. Over five sessions, the authors facilitated discussion and provided education to the trainees and course directors on various foundational elements and skills related to narrative medicine. Warm-up exercises were provided at each session, designed to “stretch” mental muscles by either encouraging participants to reduce a complex idea into just a few words, or to describe a non-written (visual or auditory) prompt as thoroughly as possible. Each session concluded with time for free writing and voluntary sharing. For the inaugural year, the authors applied an overarching narrative construct based loosely on Joseph Campbell’s, “Hero With a Thousand Faces. “Session themes included “Finding Identity,” “The Journey,” “Challenges and Transformations,” “Finding Purpose,” and “Returning with the Elixir.” After implementing the program, cumulative qualitative evaluations were analyzed. Trainees expressed overwhelming satisfaction with the format, time commitment and activities associated with the advocacy curriculum. The program continues and is currently in its 3rd year. We propose that this is an effective method to teach advocacy to pediatric residents.

Loss: building undergraduate empathy for the unknown – intentional learning from client narratives.

(Discussion session)

Corresponding presenter: Josie Crawley MEd, BA, RN School of Nursing, Otago Polytechnic, Dunedin, New Zealand Dunedin, Otago

This discussion describes how I embed client narratives, including children’s picture books and reflective student writing to lead undergraduate nursing students to explore the multiple nuances of humanity experiencing loss. Being an effective health professional requires empathetic, compassionate practice. It’s a big ask of a sheltered student, to sit with a dying patient, to walk alongside someone with a chronic debilitating disease, to understand what a client means when they say they are fatigued, or why someone might respond angrily when you are helping them. Client narratives help fill the space between student knowledge and client experience. The sharing and discussion of client narratives adds a personal voice to theory, an interpretation of what health and change might look like through a client lens. We will discuss a reflective storytelling model for working the client narrative. The narratives themselves are powerful, but the discussion scaffolded about them turn an emotional touchstone into nursing cues of how to explore meaning and be with the person in partnership – rather than doing things to the patient. The model leads you through these stages, using the narratives as a basis for student critical thinking and reflection.

Sustaining a Literary and Arts Journal: Auscult at the Medical College of Wisconsin

(Discussion session)

Corresponding presenter: Alexandra Cohn Mami Sow MSt Ancient Philosophy, current second year medical student Medical College of Wisconsin Milwaukee, WI

The Medical College of Wisconsin publishes Auscult, a literary and arts journal, annually. This student-led publication includes stories, poems, and visual art created by individuals from the MCW community. In this session we plant to discuss our latest efforts to produce a sustainable journal, with a focus on increasing submissions. Towards this aim, we have started a new podcast in which we interview contributing authors, read their work aloud, and discuss their creative process and the importance of the humanities in their lives and careers. We will also discuss a book launch event and partnerships with other student organizations on campus. It is our hope that describing our process can provide one example of how to foster a community-wide appreciation for the humanities in the context of medical education.

Fact versus Fiction: Writing About Experiences in Medicine

(Discussion session)

Corresponding presenter: Lila Flavin MD NYU Langone Brooklyn, NY

In writing, it is the details that make a story come alive. We remember the number of cats a character had, the description of their laughter, and the missing button on their shirt. As doctors, we have taken a vow (otherwise known as HIPPA) to protect the specifics of our patients’ lives. And yet as doctors who write, we have to tell our stories. How do we find freedom in our creative life when there are some stories or some details so unique, so traceable, that we cannot share them? How do we cope with this restriction? Do we embed our patients in the fiction we write? Do we ask their permission, fully knowing that we continue to hold more power in the relationship? Do we change the details of their life even when it is the details that truly make a story? In this workshop, we will read excerpts from several essays that have been written on the topic including work by Perri Klass, Danielle Ofri, and Lori Gottlieb. Participants will discuss these questions as a group and generate strategies to use in their own writing and storytelling. No prior writing experience is necessary. This workshop is for anyone who has a story to tell.

Developing Story-Based Content that Influences a Culture of Safety in Medicine

(Discussion session)

Corresponding presenter: Tracy Granzyk MS, MFA MedStar Health Institute for Quality & Safety Chicago, IL

Preventable medical harm is a global issue affecting everyone around the world. The World Health Organization found patient harm to be the 14th leading cause of the global disease burden, comparable to tuberculosis and malaria. It is the third leading cause of death in the United States though still unrecognized as such by the Centers for Disease Control. Communication and the medical culture are often at the root cause of medical harm, leaving room for improvement in both areas. The MedStar Health Institute for Quality & Safety has been developing stories and narratives of both patients and providers to connect the heart and the head of those delivering care, improve patient engagement and the delivery of patient-centered care, and aid in the adoption of a high-reliability culture. By attending this session, attendees will: 1) Understand where stories and narratives are being used within healthcare to build a transparent culture of safety; 2) Know where to access existing tools and resources that can serve as a model or starting point; and, 3) Learn ways to acquire and shape stories from within their existing health system or patient population that can be operationalized to inspire internal culture change.

Using an Electropsychedelic and Neural Biofeedback Loops

(Discussion session)

Corresponding presenter: Jason Snell B.A. in Mass Communication and Journalism, University of Iowa, 1998. Independent Artist Cedar Rapids, IA

Please enter a well-developed abstract for your presentation, written as you would like to see it in a finished program (ie, do NOT write it as a proposal). If your proposal includes elements of educational methodology for healthcare professionals teaching in undergraduate or graduate medical education, or practice management for healthcare professionals interested in providing better service to patients, please describe those elements. This and all information on this form will be used to construct the conference program. Please check spelling and grammar. Maximum length: 1750 characters, (approx. 250 words). Using an Electropsychedelic and Neural Biofeedback Loops Although commonly used in association with hallucinogens, psychedelic literally means to manifest the psyche (Greek psukhē dēlos). Using his custom-built EEG system, Jason Snell is able to manifest brain activity into music and visual displays. What began as an art project that enabled him to make music with his mind quickly became a study of the brain and the electrical activity that inhabits it. The system’s biofeedback feature – the brain reacting to the music it is producing in real-time – has enabled users to explore the relationship between perception and creation, experience the difference between the brain and the consciousness, and to explore the mind like a physical space using the sounds as a type of echolocation.The session will include a short performance by Snell, questions and discussion with the audience, and the opportunity for audience members to use the system themselves.

The Lure of the Flash Essay

(Discussion session)

Corresponding presenter: Yasmina Din Madden MFA in Fiction Drake University Des Moines, Iowa

This discussion of the Flash Essay speaks to medical professionals and others who have dealt with serious illness who are eager to write about their experiences as a way to fulfill their artistic desires while also attempting to make sense of the complexities and difficulties they have faced. The session will focus on craft elements that distinguish the flash essay, as well as on the advantages and challenges of the genre, and is fitting for writers who are new to the genre. Participants in this session will come away with an appreciation for how the flash essay opens up new opportunities for expressive and reflective writing, as well as an understanding of foundational elements of craft to consider when composing their own narratives. Flash narratives, defined by most literary journals as essays or stories of 1,000 words or fewer, have exploded in popularity in the last decade. The genre’s popularity is reflected by the many established journals that now include flash essays and stories, as well as by the plethora of anthologies dedicated to flash nonfiction and fiction. The growth of the genre speaks to the artistry and urgency of the flash narrative, something that both writers and readers are drawn to. While the genre attracts writers from a diversity of backgrounds and skill levels, several of the distinguishing elements of the genre will likely resonate with writers who are medical professionals, patients, or caregivers: They include narrative brevity and compression, the precision of language, and an emphasis on urgency and pacing.

The Aseemkala Initiative: Using Traditional Dance to Narrate Stories of Women in Medicine

(Discussion session)

Corresponding presenter: Shilpa Darivemula MD, MS Dartmouth-Hitchcock Medical Center Lebanon, NH

For centuries, women around the world have used dance to heal themselves, their homes, and their lands. Dance contains intrinsic health-promoting components when performed in its traditional setting, with traditional rituals, community, foods, and the central role of women in each component of the performance. Based on observations and results of interviews regarding the women’s role in three types of traditional dance cultures from Chile, Morocco, and Cambodia, a novel model to approach women’s health through the arts, the Aseemkala Traditional Dance Model, was developed. Instead of relying on translation and perception in global health settings, providers who wish to incorporate culture into programming can experience this culture in traditional dance systems without linguistic barriers and without the traditional power differential that complicates equal collaboration between foreign global providers and local women. This integrative model can be a guiding force to increase awareness of providers when assessing the selection and incorporation of cultural factors into their programming. Usage of this model can also give agency to global women to share their culture through their untranslated movements and to perhaps better collaborate with service providers to create the types of inventions that best suit their realities. This discussion explores the connection between traditional dance and narrative stories in medicine and the development and use of the dance model to transform women’s health.

Learning to write frankly about ourselves, our training and our profession

(Discussion session)

Corresponding presenter: Saul Weiner MD University of Illinois at Chicago and Jesse Brown VA Medical Center Chicago, IL

In 2002 Saul Weiner, a young attending physician at the time, published an essay in Academic Medicine titled “Learning Medicine with a Learning Disability: Reflections of a Survivor.” Almost twenty years later struggling pre-medical students, medical students, and residents still contact him, often to say that after reading it they felt less ashamed and more hopeful. Writing the piece was possible because of an older mentor who challenged Dr. Weiner to strip away pretentions or self-congratulatory language and to be direct and honest. His recent book, On Becoming a Healer: The Journey from Patient Care to Caring about Your Patients (Johns Hopkins University Press, April 2020), explores how the medical education process undermines the emotional development of physicians such that few are able to fully engage with their patients. Dr. Weiner describes how recognizing this dysfunction and developing self-trust can enable healing interactions with patients that are mutually nourishing. In this session, the author will discuss the challenges and value of writing with candor about the experience of becoming a health care professional. He will invite participants to talk about their efforts at writing with candor about their journey to becoming a healer.

Mirth is God’s Medicine: Therapeutic Aspects of Humor and Narrative Medicine

(Discussion session)

Corresponding presenter: Heather Thompson Buum MD University of Minnesota Saint Paul, Minnesota

Henry Ward Beecher wrote in the 1870s, “Mirth is God’s Medicine. Everyone should bathe in it. Grim care, moroseness, anxiety–all this rust of life–ought to be scoured off by the oil of mirth.” Fast forward to current times; with so much focus on physician wellness, finding humor in our everyday practice–and writing about it–may be an antidote to burnout. But many will wonder if or when this is truly appropriate. Can we compose a humorous narrative about the worst code we ever ran, or the patient who is convinced they have a disease which doesn’t exist? Are jokes about cancer even funny? For those of us who have also been patients, is poking fun at the ridiculousness of our healthcare system therapeutic, or just airing our own dirty laundry? This session will explore the issues surrounding the use of humor both in daily interactions and also as a component of narrative medicine. We begin with a review of the literature on the effects of humor and laughter on health outcomes. Guidelines surrounding the appropriate use of humor in medicine will be discussed. We then move toward humor as a coping mechanism when dealing with difficult situations, including writing projects that utilize this approach. Ultimately, finding joy in the practice of medicine and mitigating burnout may be facilitated by allowing ourselves to discover the humor in the everyday and the mundane.

Persistence of Memory: Investigating Polio Stories

(Discussion session)

Corresponding presenter: Nina Stoyan-Rosenzweig MA University of Florida Gainesville, Florida

Writing history is inevitably an act of narrative faith. It requires faith in the primary sources. And faith in the ability to interpret those materials, understanding what the voices tell us about. And it also means having the faith in one’s knowledge of other factors influencing what and how stories are told, from a range of possible forms. It requires faith in one’s ability to take the time to tease out the other voices- editorial, cultural (in the case of illness narratives, the cultural voice emphasizes triumphant illness narratives), financial, and others, that shape the narrative. Reading the story of the polio epidemics striking the United States in the early to mid-20th century is a challenge. Much is known about the events, and we hear stories from many of those who had polio. But because of the demographics of those who had the illness, the stories for the most part are filtered through memory. Thus, they are not contemporary records of events. What if there is a contemporary account, written in a 6 year old girl’s voice? But written by her mother? Or else a retrospective by a storyteller with a remarkable memory for details? This paper discusses the history of the 20th century polio outbreaks, and explores the way in which stories are constructed using oral histories, autobiographies, and a unique journal (soon to be published by the UF Library Press). Comparing and contrasting these several sources, especially the first-hand accounts from different sources, shows how the perspective and storyteller illuminates and further completes the story of it impact on individuals, families, and societies.

The Hospice Doctor’s Widow: A Love Story with Art and Some Practical Insights

(Discussion session)

Corresponding presenter: Jennifer O’Brien MSOD hospicedrswidow.com & KarenZupko & Associates Little Rock, AR

Please join this conversation about when a hospice and palliative care doctor receives a stage IV, metastatic cancer diagnosis and his physician-practice-management-consultant wife takes care of him through his 22-month illness while taking care of herself by art journaling. Jennifer O’Brien will share her experience with art journaling as selfcare, thoughts relevant to end-of-life and family caregiving, as well as the wisdom of her late husband, Bob Lehmberg, MD, a hospice and palliative care physician as a means to initiate and facilitate this session. Jennifer will tell of her experience with regret prevention as it pertains to her own survivorship. She will share the death preparation they did, which was so clearly a demonstration of their thorough understanding of end-of-life realities and their profound love for each other. She will explore both the seeming advantages they had, having been on the provider side of healthcare and the mistakes they made for that very same reason. During the session there WILL be art, stories, insights, lessons learned, mistakes made, laughter, vulnerability, resources, compassion and support. Participants MAY experience: new perspectives, tears, enhanced understanding and difficult realizations. In this discussion session, there will be NO: judgement, criticism, finger wagging, directives or “Shoulding.”

The Art of Storytelling in Medicine: Revolutionizing Well-Being in Cancer Patients and Caregivers Through Writing and Performance

(Discussion session)

Corresponding presenter: Samanth Olson PhD Candidate in English and Master of Science in Journalism St. John’s University and Stony Brook University Hoboken, New Jersey

Research has shown that patients who engage in expressive writing interventions to tell their stories of illness can experience a profoundly positive impact on their well-being. Yet, there continue to be limitations to studying its effects on patient populations, and the mental health hardships that people are left to contend with as a result of cancer are often sidelined—burdening patients, survivors, and their loved ones with significant emotional consequences. This paper considers the positive impacts of Visible Ink, Memorial Sloan Kettering Cancer Center’s one-on-one writing program that offers patients and caregivers the individualized support of a professional writing mentor. Each year select pieces are published in an anthology and performed on stage for a live audience by volunteer Broadway actors. Through analysis of Visible Ink, I will argue that the experience on both paper and stage clarify the writer’s identity to him or herself by translating emotions into words—solidifying the importance of storytelling and performing arts in the medical field. As a supplement, I will review a study published in the journal Palliative Support Care that assessed the effectiveness of Visible Ink. By examining the program’s impact on patient well-being through anecdotal and clinical evidence, I will demonstrate that expressive writing intervention models are vital to mental health across many, if not all, patient populations. The future of writing intervention programs in the medical field is a continually emerging story intrinsically tied to mental health prioritization in healthcare—one that, if embraced, I assert has the power to propel patient care forward and revolutionize healthcare.

Using First-Person Narratives of Neurodiversity to Enhance Communication and Understanding

(Discussion session)

Corresponding presenter: Brooke Kowalke PhD in English Creighton University Omaha, NE

The school of medicine at Creighton University recently underwent a global curricular revision. During that process, we used an internal innovation grant to develop a five-week medical humanities seminar elective in “Narratives of Neurodiversity: Appreciating variations in cognitive ability to enhance communication and understanding”. This was offered to first- year medical students in their fall semester. The course aimed, “through engagement with theories of language, disability studies, and personal narratives” to 1) Examine how clinical language (and the implicit value statements therein) impact the lived experience of families living with neurodiversity; 2) Explore clinical approaches that embrace neurodiversity and affirm whole and complex personhood; 3) Evaluate what concepts of ‘goals of care’ and ‘quality of life,’ might mean when coming from a variety of perspectives. In this session, we will discuss our experience with teaching the class and the revisions we have undertaken to center the voice of the neurodiverse individual and her/his experience of the world. We found that some students struggled to connect with theoretical materials and that some had a difficult time with modes of discussion that involved literary analysis and interpretation. We hope to engage with session participants about strategies for building trust within the classroom and for encouraging students to “take risks” as they discuss literary narratives that immerse them in experiences that are unlike their own.

Unforgettable, part of the Artist—Art and Illness series at the University of Iowa Hospitals and Clinics

(Featured Presentation)

Corresponding presenter: Bruce Scherting MFA, fine art, Southern Illinois, Carbondale University of Iowa Hospitals and Clinics, Project Art Iowa City, Iowa

Project Art’s mission is to enhance and transform the UIHC healthcare environment through the arts by providing aesthetic, contemplative and visual thinking experiences for our patients, families, visitors and staff. This presentation will provide an overview of the Artist—Art and Illness program and introduce our 3rd exhibition in the series. The artists in Unforgettable give visual form to the emotions that accompany watching a family member or friend struggle with dementia. In sharing these intensely personal experiences, they invite us to consider the impact of Alzheimer’s disease and other forms of dementia on our most intimate relationships. Nearly 6 million Americans are currently living with dementia, and that number is expected to double by 2040. Truly dementia is among us and within us. Through these varied art practices, a deeply emotive narrative develops encouraging empathy while illuminating the lives of those affected, their family members, and caretakers. Participating artist and session presenter Marguerite Perret will discuss two related bodies of work. The Last Resort is a mixed media installation that reflects Perret’s mother’s distress living in a retirement community as her cognitive and physical capacities diminished. Suspended refers to Perret’s father who suffered from vascular dementia and compared it to trying to keep his head above the (metaphorical) waters. In both instances, Perret witnessed the anxiety and frustration of her parents, but also at times, a peacefulness that came with living fully in the present. Beyond recognition of the sorrow and loss, this exhibition is a celebration of the love that is truly unforgettable. Exhibit on view, UIHC Medical Museum, elevator F, level 8.

Writing to Save Lives and Other Acts of Healing

(panel discussion)

Corresponding presenter: Christine Stewart Ph.D. South Dakota State University Brookings, SD

These two panelists, published authors and mothers of chronically ill children, will discuss the importance of writing as a healing act of self-care. The first panelist will illustrate how her mothering and writing practices began to parallel each other, giving her strategies (observe, research, revise) for success and survival in both. The second panelist will outline how historic medical research played a part in accepting and reframing living with a chronic disease. Likewise, she will discuss how her creative process now involves research and other methodologies. The two will end the session with a generative writing workshop aimed to help attendees apply new insight to their own writing practice, however emerging or advanced that might be.

Metaphor, Illness and Meaning: The Aesthetics and Ethics of Writing Pain

(panel discussion)

Corresponding presenter: Anne Sand Masters of Fine Arts, Nonfiction Writing University of Iowa Iowa City, Iowa

Pain and illness are inherently individual experiences. The sensations of the body are perhaps the hardest thing to communicate to someone outside ourselves, because those sensations resist our attempts to capture them with words. Because of this, we often turn to metaphor to talk about pain, saying pain is “burning” or “stabbing” when neither is literally happening. Expand this out, and we also commonly use metaphors to talk about our experience of pain and our relationship to it. Virginia Woolf wrote that simply being brought down by influenza could reveal the “wastes and deserts of the soul.” While Susan Sontag wrote about “full-blown AIDS”, the phrase that was code for “inevitably fatal” when talking about the disease, but which originally referred to flowers in full bloom. Such metaphors take on particular significance when we consider the sociological studies of George Lakoff and James Geary which suggest that human brains are so attuned to metaphor that we will naturally extend the metaphors we hear and read to form whole frameworks of meaning. In other words, the metaphors we use to describe our pain and others’ could determine whether readers sympathize with or judge people experiencing similar pain or illness. In this panel three writers and educators will talk about the metaphors they have read and used for pain and disease, exploring the aesthetic and ethical ramifications of those metaphors and what the responsibility of the writer might be in using them.

How to Write Medically: A Creative Writing Workshop for Trainees

(panel discussion)

Corresponding presenter: Kacper Niburski B Arts Sc, MA, MD (candidate) McGill University Hamilton, ON

Background: Writing workshops have recently been used to increase critical reflection in medicine. Yet few studies have looked at the benefits of creative writing, the literary techniques relevant to medicine, and the clinical effect of writing. Aim: Evaluate the effects of creative writing, including empathy, dealing with uncertainty, and technical competence, on medical practitioners. Method: A four-month course was created alongside an author and a neurologist. 11 were selected. Workshops consisted of pre-reading, interactive lectures, writing prompts, and a discussion of the participants’ pieces, for a total of two hours. Data was collected on pretest and post-test skill-level, frequency of writing, confidence, empathy, and perceived relation to patients. Statistics were calculated with SPSS25, with U-Mann Whitney for non-normal distribution. Qualitative data of open-ended questions was coded using thematic analysis. Results: 80.2% reported a subjective increase in confidence in their writing skills. Frequency of creative writing immediately after and 1 month after the intervention increased by 89% and 80% respectively. Empathy was self-observed to increase by 60%, as well as dealing with uncertainty by 75%. 90% of participants reported that they could better understand patients, with their self-reported clinical communication improving by 73%. All (11/11) stated the course had utility and should be widely applied in medicine. 54% were able to publish their work in peer-reviewed journals after 1 month, of which 81% had never tried before the class. Conclusion: Literary focused writing workshops improve self-reported assessments of medical competencies, objective measures of creativity, and opportunities to publish.

Brittlesweet: Humor Amid the Trauma and Tragedy of Diabetes

(performance)

Corresponding presenter: Sheila Lintott PhD Bucknell University Lewisburg, PA

Brittlesweet: Humor Amid the Trauma and Tragedy of Diabetes is a one-woman comedy show exploring the coping mechanisms of a family whose matriarch suffers with uncontrolled diabetes from the perspective of her youngest child. Following the performance, the comedian will answer questions and lead a discussion about the promise and perils of comedy as a coping mechanism.

Journeys End, Journeys Begin

(performance)

Corresponding presenter: Shapir Rosenberg MD – Denver, CO

In this performance piece, a mother and her son’s physician tell stories within a story, in many voices, of a young man’s life–his smile and vitality, his homelessness and drug use–and of his death. Told in monologue and dialogue, through words and images, via hospital records, police reports, and poetry, it is a moving tale of love, loss, caregiving, and healing. With compassion and vulnerability, humor and creativity, mother and doctor grieve and transcend, together.

It sounds messy. It sounds MSsy: poetic inquiry as a methodology for exploring lived experience of multiple sclerosis

(performance)

Corresponding presenter: Georgi Gill MA Creative Writing (Poetry) Distinction, currently in third year of PhD in Health in Social Science University of Edinburgh Edinburgh, Lothian

Like many individuals with multiple sclerosis (MS), I have achieved some fluency in medical MS terminology in an attempt to participate meaningfully in the established bio-medical discourse of the consulting room. This, however, does not adequately represent my voice or give a truthful representation of my subjective experiences, that which phenomenologists might term my ‘view from here’. As a poet, unsurprisingly, the way I have chosen to articulate these experiences is by writing poetry. In my PhD research, I invite other people with MS to explore their individual health experiences through writing poems. We then share some of those poems with our MS consultants and nurses in order to address the following research questions: Can the use of poetry in this project help participants, me and potentially our readers to develop new understandings of our relationships with our ill bodies? Can writing poems give us the opportunity to articulate some of the untidy and uncertain aspects of our lived experiences of MS? If so, does introducing poetry to the patient-practitioner dialogue influence that relationship so as to affect the power dynamic which is usually heavily weighted in favour of the medical practitioner? In this presentation, I will share my preliminary findings by discussing themes that have emerged from the data and illustrating these themes with example poems written by myself and participants.

Podphylaxis: Live Podcast at The Examined Life Conference!

(performance)

Corresponding presenter: Christoffer Amdahl BS, MD candidate University of Iowa Carver College of Medicine Iowa City, IA

Podphylaxis is a medical interest podcast that was started by two UI CCOM students during their second year of medical school and has since expanded into a Student Doctor Network partnered program. Christoffer Amdahl and Erik Kneller discuss non-traditional student stories, current issues in medical education, and blend story-telling elements with up-to-date medical questions in sessions such as Doctors and Dragons and Moonlighting to provide a fresh perspective on studying for medical school exams.

Using guided group narrative to honor a physician colleague, acknowledge his legacy, and help his family and the rest of us deal with his death

(poster)

Corresponding presenter: David Thoele MD Advocate Children’s Hospital Chicago, IL

Narrative has long been used to help the living cope with death. Most cultures have rituals after a person dies, including eulogies, testimonials, sermons, and music. After I worked closely with Ira, a fellow pediatric cardiologist, for 15 years, my dear friend passed away. Following this, there was a service at the hospital, attended by members of his family, colleagues and patients. After sharing my memories, I made an unusual request. Our narrative medicine group created a writing exercise, the 3-Minute Mental Makeover, which involves saying the story of your life in exactly six words. Because Ira was a role model, I suspected others felt the same way, so I invited people to write the story of Ira’s life, in exactly six words, and contribute memories they had of Ira during his 35 years at our hospital. I put these stories into a book, printing copies for his wife, children, and grandchildren. The “I Love Ira” books were placed in ICUs and units where we worked together, as well as in the IDEA (Ira Dubrow Educational Atrium), a library/educational area for residents that honored Ira and his life-long love of teaching. I emailed the book to every person who contributed. This poster will include the group narrative we created, and reflections from Ira’s family on what it was like for them to receive this book. I will have a copy of the book available, and discuss the powerful healing effect of this project after I lost my brother and friend.

Narratives in Anatomy: Holding space for students to dissect emotions and reactions to death, dying, and professional identity formation during anatomy lab

(poster)

Corresponding presenter: Hannah Daneshvar Bachelor of Science Tulane University School of Medicine New Orleans, LA

Background. The experience of human dissection is emotionally fraught and one of the most memorable rites of passage among medical doctors. Recognizing this, and in keeping with trends in the literature, the authors designed and piloted a novel, voluntary curriculum entitled “Narratives in Anatomy” (NIA) to complement the anatomy course for first year students in Fall 2019. NIA draws from narrative medicine pedagogy, with weekly facilitated discussions on students’ transition to medical school, experiences in the lab, perceptions of death and dying, and professional identity development. Results. At the conclusion of NIA, students who participated in at least one session (n=64) were invited to provide feedback on the course design and its personal impact on their experience acclimating to lab and medical school. The responses (n=30) were de-identified and aggregated. On a Likert scale of 1-5, with 1 as not helpful and 5 as extremely helpful, average student opinion toward NIA intervention scored 3.5 versus usual practice, 2.3. The majority of respondents felt the course was helpful to extremely helpful (79. 3% scoring 3-5.) Further, 56.7% of students believe that discussion spaces similar to NIA should be mandatory for incoming students. Conclusion. Through use of the humanities, dedicated time for reflection on death and dying during anatomy lab can provide many benefits. Drawing from the authors’ experience and the students’ reception of the pilot, our article offers best practices for course design, session structure (e.g. themes and material selection), and facilitation techniques.

Narrative Writing in Pre-Clerkship Medical Education as a Tool for Developing Empathy and Professional Identity Formation.

(poster)

Corresponding presenter: Christina Seto BA (English, Neuroscience & Behavior) University of Central Florida College of Medicine Orlando, FL

BACKGROUND: Narrative medicine allows medical students to develop empathy and professional identity. Our study explored narrative writing as a tool for University of Central Florida College of Medicine (UCFCOM) medical students to process early clinical experiences during the first two years of medical school and to develop professional identity. METHODS: We performed a retrospective thematic analysis (NVivo®) of 40 deidentified narratives written by UCFCOM students during pre-clerkship clinical experiences from 2015-2017. Central themes were identified and converted into quantitative data (percent coverage). We correlated these themes to categorical measures of career choice using residency match data. Narrative themes (i.e. percent coverage) were compared to career choice using one-way ANOVA. RESULTS: We identified three central narrative themes: (1) Anticipating future career as a physician [“I hope that I never lose sight of the human behind the diagnosis”], (2) Emotion toward the patient [“She is my role model of caring and kindness, and I will try…to live up to her”], and (3) Expectations vs. reality [“Patients are not clinical vignettes on exams…They are real and living and their stories matter”]. Quantitative comparison of narrative themes and career choice found no significant differences in themes between groups. CONCLUSIONS: Central themes appear in narratives with almost equal frequency regardless of career choice, suggesting that narrative reflection is a powerful tool for all medical students to foster a sense of empathy for their patients and a sense of purpose in their chosen profession. As medical students ultimately become practicing physicians, a strong foundation of humanity is essential.

The Power of Words: Exploring the Therapeutic Effects of Poetry Among Hospitalized Pediatric Patients

(poster)

Corresponding presenter: Anna Delamerced BA Warren Alpert Medical School of Brown University Providence, RI

BACKGROUND Hospitalized pediatric patients may experience fear, worry, and stress. It is important to address their wellbeing. This study sought to investigate the possible therapeutic effects of poetry on hospitalized pediatric patients’ physical and emotional health. METHODS Consent was obtained from inpatient pediatric patients and parents/guardians. Participants completed pre-activity questionnaire assessing symptom burden –validated “PedsQL Present Functioning Visual Analogue Scales” on fear, sadness, anger, worry, fatigue and pain in the present moment (PedsQL VAS). Participants then completed the poetry activity: a brief poem-writing activity on acrostic poems, haikus, or free-form; and/or reading pre-selected poems. Post-activity, parent/child dyads completed the same PedsQL VAS questionnaire and open-ended qualitative survey on their experience. RESULTS Data from 30 participants were analyzed. Wilcoxon Signed Rank Test showed brief poetry intervention resulted in statistically significant reduction in PedsQL VAS symptom measures: fear (p=0.043), sadness (p=0.018), anger (p=0.043), worry (p=0.043), fatigue (p=0.001), and pain (p=0.042). Participant feedback from qualitative survey: “I feel happy”; “very fun”; “I am a poet!”. Parent feedback: “Engages children in creative and intellectual ways”; “offers a screenless activity”; “gave positive reinforcement through words”. CONCLUSION Through a poetry intervention, this study found statistically significant reductions in symptom burden among hospitalized pediatric patients. Providing space for poetic expression reduces children’s feelings of fear, sadness, anger, worry, fatigue, and pain. Future aims: increase sample size for further analysis.

Can the Medical Humanities Enhance Student Empathy?

(poster)

Corresponding presenter: Catherine Elko Bachelor of Science University of Florida College of Medicine Gainesville, FL

Background: Physician empathy is integral to the doctor-patient relationship, as it leads to improved rates of patient satisfaction, compliance, and outcomes (Tsao & Yu, 2016, p. 1). Unfortunately, traditional medical training leads to a decline in student empathy (Spatoula et al., 2019). The question then arises: how can educators enhance student empathy throughout their medical training? Objective: This paper hypothesizes that by integrating the humanities into medical training, educators will help maintain or enhance student empathy levels. Methods: Using Pubmed and similar databases, a literature search was completed for studies which measured the effects of humanities interventions on student empathy by quantitative and/or qualitative means. Results: Of the twenty-three studies that were evaluated, the results of sixteen fully supported the hypothesis that humanities interventions maintain or enhance student empathy. Conclusions: Most of the evaluated studies showed evidence to support the hypothesis that humanities interventions in medical education maintain and/or enhance student empathy. Medical educators should continue to explore this area of research, as the humanities may be the key to shaping students into well-rounded, empathetic doctors. References: Spatoula, V., Panagopoulou, E., & Montgomery, A. (2019). Does empathy change during undergraduate medical education? – A meta-analysis. Medical Teacher, 1-10. doi: 10.1080/0142159X.2019.1584275. Tsao, P., & Yu, C. (2016). “There’s no billing code for empathy”-Animated comics remind medical students of empathy: a qualitative study. BMC Medical Education, 16(1), 204. doi: 10.1186/s12909-016-0724-z.

Chinnamasta’s DNR Order: Performing Shared Decision Making: Using Classical Indian Dance to Understand ICU Patient-Provider Communication

(poster)

Corresponding presenter: Kritika Amanjee MBA Albany Medical College Albany, NY

Purpose: : The main goal is to choreograph the process of shared decision making between a physician and patient in the ICU through Kuchipudi and Bharatanatyam dance to explore the elements and challenges around communicating nonverbally in high acuity clinical setting. Content: : Through choreography, performance, and post-performance discussions, the performers noted increased awareness about shared decision making as a tool in modern medicine, and the importance of identifying values of care in end-of-life instances. The pervasiveness of machines and numbing sounds, the emotional needs of the families, the expressions and subtle movements of patients attempting to communicate, the ephemerality of the provider in the patient’s room preventing prolonged communication, and the varying states of consciousness in the ICU were identified as specific and important elements in need of care during shared decision making decisions. Clinical Implications: : Performing physician and patient roles in shared decision-making scenarios using the narrative, expressive style of traditional Indian dance can improve understanding of nonverbal communication and shared values of both physician and patient. As medical students choreographing and performing this piece, the emotional aspects of communicating on end of life care were deeply explored, specifically the emotional barriers of both patients and providers preventing open channels of discussion. Future work should focus on performances with audience-based data collection or teaching this choreography to medical student-performers with pre- and post- testing to assess improvement in SDM skills.

Birth and Blame: Exploring Social Pressures Around Birth Using Traditional Dance

(poster)

Corresponding presenter: Virali Shah MBA Albany Medical College Albany, NY

The idea of “natural birth” impacts perceptions of birth, romanticizing the unmedicated, vaginal delivery and idealizing it as the epitome of female strength and entrance into motherhood. Unfortunately, due to maternal or fetal needs, unplanned cesarean sections occur, causing multiple women to experience feelings of guilt, shame, and disappointment in themselves. These societal pressures impact peripartum mental health negatively. To address the need for increased provider attention on the impact of delivery on women’s self-perception of birth, Tripura’s Birth dance was choreographed. This piece uses Kuchipudi and Bharata Natyam, two forms of Indian classical dance, to create a choreography based on embryological development and the beauty of birth in all forms. From the single cell, to the blastocyst, to the gastrula, to the closing of the neural tube, the growth of the placenta and spiralization of the placental arteries, the development of the heart, lungs, and limbs, and finally the process of birth, this piece creatively celebrates the complexity of fetal development and the strength of a mother to choose the right way for her baby to enter the world—a decision that reflects true strength and ideal motherhood. Through observing the performance, medical professionals not only learn the fundamentals of medicine but also reflect on the societal implications related to healthcare and the need to change our views on birth. They understand that a healthy mother and child—the hardest won goals of modern obstetrics—matters more than the mode of delivery and can support new mothers accordingly. Performance: https://www.youtube.com/watch?v=8de_QKlzEa8

Mouth & Toes: The World of 19th Century (Performative) Silhouette Artists with Disabilities

(visual art display)

Corresponding presenter: Marianne Petit BA, MA, MPS Interactive Media Arts / Interactive Telecommunications Program New York University, Tisch School of the Arts Brooklyn, NY

“Mouth & Toes: The World of 19th Century (Performative) Silhouette Artists with Disabilities” is an illustrated and animated hybrid book. It shares the stories of Martha Anne Honeywell and other 19th Century disabled artists who became famous not only for their work as silhouette artists but for creating their intricate paper cuts as public performances. Martha Anne Honeywell was born without forearms and hands and with only three toes on one foot. She was known for her silhouette, paper cutouts, embroidery, needlepoint, and penmanship. An astute business women, she would often perform up to three shows a day, charging fifty cents per ticket for her two-hour performance, and an additional twenty five cents per silhouette. She performed with other lesser known disabled artists including Sarah (Sally) Rogers and Sanders Nellis. “Mouth & Toes: The World of 19th Century (Performative) Silhouette Artists with Disabilities” is an illustrated book created in the form of silhouette, containing audio and animation. It will be completed in 2020 through a Creative and Performing Artist / Writer Fellowship at the American Antiquarian Society. The American Antiquarian Society contains an extraordinary collection of American silhouettes, as well as the broadsides and newspaper advertisements for the traveling silhouette cutter. The book tells the little-known story of the performative world of disabled and atypically figured artists working in the very popular and affordable alternative to portraiture, the silhouette. Its final form(s) will be a small black and white illustrated book (with animation accessible through AR) as well as an e-Book.

“No Ideas But in Things”: Writing micro-essays on health, illness, & healing

(Workshop)

Corresponding presenter: Jody Keisner Keisner MA in English, MFA in Creative Nonfiction University of Nebraska at Omaha Omaha, NE

In this interactive and generative workshop session, we will discuss “No Ideas But In Things,” the famous phrase from William Carlos Williams’s lengthy poem Paterson. Together we will read published essays that utilize this technique and discuss how we might apply it to our own writing. “No Ideas But In Things” asks the writer to replace an abstract idea with a concrete object (a thing), moving the object toward symbolism. The workshop will focus on the 250-word micro-essay and on themes of health, sickness, and healing. Participants will generate ideas for micro-essays and discuss works-in-progress that may benefit from “No Ideas But in Things.” Though focused on creative nonfiction, this workshop is perfect for beginning and advanced writers of any genre.

Metaphor in Medicine: Using Poetry to Build Healthcare Professionals’ Tolerance of Uncertainty and Reflective Capacity

(Workshop)

Corresponding presenter: Michelle Tong MS Icahn School of Medicine at Mount Sinai New York, NY

Tolerance of uncertainty is a learned skill that can be a protective factor against burnout. Healthcare professionals have traditionally employed the humanities to teach related skills, such as empathy, listening, and reflective capacity, but the selected texts are usually limited to fiction and nonfiction. We propose that the close reading of poetry, a genre that does not always provide narrative resolution in the same way as fiction or nonfiction, is the ideal medium to support residents in building tolerance of uncertainty while also honing tools for critical analysis. This workshop will present the curriculum and survey results from the pilot semester of Metaphor in Medicine, a series of five, two-hour poetry classes, at the Icahn School of Medicine at Mount Sinai. This elective course paired clinical topics (reproductive health, aging, disability, substance use, LGBTQ+ health) with craft lessons in poetry (theme/meaning, structure, figurative language, sound, verse forms). We will lead a shortened version of one class to demonstrate how the content can be condensed to individual programs’ needs.

The Healing Power of Writing

(Workshop)

Corresponding presenter: Caroline Johnson B.A., English, University of Michigan; M.A. English Education, University of Chicago University of Chicago; University of Michigan Willow Springs, IL

Some things are difficult to talk about, such as cancer, Parkinson’s, Alzheimer’s, or other chronic illnesses. Sometimes it is easier to write about a disease that you or a loved one are experiencing. Maybe you’ve suffered silently with a sickness, or you’ve worked tirelessly as your husband’s caregiver. You need some relief. There is a long history of writing poetry and prose as a way of healing, especially the healing of the emotions. This workshop will focus on writing as a means of healing from illness or grief. Through writing prompts and listening to example poems, participants will get a chance to write and share their stories via poetry or prose. The presenters will share some examples from the past, as well as their written responses to dealing with the strain and rewards of caregiving, grief from the illness and death of loved ones (including a child), and facing cancer. Participants will be given the opportunity to write poetry or brief prose pieces based on their own experiences. Whether you are a caregiver, a medical professional or counselor, or someone who is being cared for, you will find something in this workshop to write about.

Same Events/Different Narratives: Our individual perspectives change the story.

(Workshop)

Corresponding presenter: Lara Ronan MD Dartmouth Hitchcock Lebanon, New Hampshire

The stories that we tell ourselves are highly personal and biased. One event or series of events can be told from different perspectives. This can be a successful technique used in novel, but in the practice of medicine and in real life can lead to misunderstandings and conflict. Through the telling of the story a patient experience, and the variations of the illness narrative that occur when different parties to the event are asked to relate the story, the audience will be challenged to recognize and identify their own potential biases. The differential emotional processing of narrative styles experienced in medical practice will be examined to elucidate where distance and depersonalization may be encountered. Prompted writing exercises using different lenses will be used to find points of agreement in a narrative and points of conflict or tension.

Inklings: Going Home with a New First Draft

(Workshop)

Corresponding presenter: Serena Fox MD Mount Sinai Beth Israel Medical Center New York, NY

The purpose of this workshop is to put the inkling of a new idea for a piece of writing onto paper. Anyone wishing to try a hand at a first draft is welcome. All genres including poetry, essays, editorials, fiction, non-fiction ad infinitum are fair game. We will write something new for about one third of the session and then read our embryonic work and offer only constructive comments for the remaining time. In medical settings we are often pressed for time, with meaningful exercises transforming a patient or professional experience in minutes. I want to expand the amount of time at this conference that we give ourselves to actually get a new idea onto paper and to provide an encouraging environment for initial feedback.

Wounded Storytellers: Responding to Stories of Trauma

(Workshop)

Corresponding presenter: Ann Green Pd.D. Saint Joseph’s University Philadelphia, Pennsylvania

This hands-on workshop will use sample texts to discuss assigning and responding to writing about the “tough stuff”—cancer, hospice, the ICU, and mental health diagnoses. Participants will consider what Arthur Frank has called “the wounded storyteller” as she appears in writing about illness and trauma. We are two writing teachers in the medical humanities and a pharmacist turned writer, and we are interested in exploring how we have written about our own medical and mental health related events, as well as how we respond to students and others who are writing about trauma and illness. We will offer suggestions for telling a traumatic or difficult story as well as reflecting on how to respond to “wounded storytellers.” While writing about illness and trauma is potentially “healing” for the writer, we will consider the limits of healing, the challenges of revision, and the possible consequences of writing as retraumatizing. We are particularly concerned with the ethics of responding to stories about illness and how the subject position of writers—their intersectionality and race, class, gender, sexualities, and dis/abilities—affect the response. For example, Black women have worse medical outcomes in part because their stories are not heard (McMillan Cotton and others). By writing our own difficult stories, what can we learn about listening to other voices, responding to trauma narratives, and embracing empathy? Workshop members will be invited to respond to sample essays, raise concerns about disclosure, and leave with ideas about effective response strategies and their own writing.

Cultivating Self-Compassion Through Reflective Writing

(Workshop)

Corresponding presenter: Sarah Wingerter MD Boston University School of Medicine Brookline, MA

Health professionals and caregivers often are skilled in extending compassion to others but may have difficulty offering themselves the same kindness and understanding, especially when they fail to meet their own expectations or when they experience a difficult or undesirable patient outcome. They may recognize in themselves signs of burnout and other forms of fatigue but may not know how to address them. Those who do not identify themselves as burned-out may be unsure how to avoid becoming one of the statistics. Self-compassion—comforting and caring for oneself in difficult times—can mitigate feelings of isolation and improve workplace performance. This workshop will focus on reflective writing as a tool for cultivating self-compassion. A practice of structured self-reflection can mitigate factors—internal and external—that lead to burnout. Reflective writing requires little equipment, may be deployed anywhere, takes just a few minutes, and can be a portal to compassion for self and others. It can be a manageable first step in a self-care regimen. This workshop will include a brief guided meditation, close reading of a poem, in-class writing, and an opportunity to share one’s writing. Participants will leave with writing prompts and strategies for developing a sustainable reflective writing practice. They will use close-reading tools to sharpen their observational skills and fortify their capacity for reflection. They will learn to use short time periods for reflective writing and will gain experience with sharing their writing in a peer-group setting and in responding to others’ writing. They may also become resources for each other and their organizations in supporting the work of self-reflection and self-compassion.

In Plain Sight: Sleight of Hand and Misdirection in Nonfiction Narrative

(Workshop)

Corresponding presenter: Philip Weitl MFA in Creative Writing Doane University Lincoln, NE

In the wildly popular Netflix series The Haunting of Hill House, adapted from the 1959 novel by Shirley Jackson, the character of Steven Crain remarks, “A ghost can be a lot of things: a memory, a daydream, a secret, grief, anger, guilt. In my experience, most times a ghost is a wish.” Gothic horror does this well: the struggle of humanity against unnatural forces, set in a bleak and inescapable place, allows what we dare not say to hide in plain sight, camouflaged in monstrous form. Nonfiction writers do not have the luxury of such disguise, or do we? In his introduction to The Art of the Personal Essay, a sweeping anthology of creative nonfiction, Phillip Lopate writes, “The spectacle of baring the naked soul is meant to awaken the sympathy of the reader, who is apt to forgive the essayist’s self-absorption in return for the warmth of his or her candor.” Such vulnerability can have consequences, especially for artists and writers today who double as caregivers and teachers bound by HIPAA, mandatory reporter duties, and our own ethical standards of privacy and discretion. The specter of these concerns is powerful and real, but so too is the instinct to seek meaning in the pain and poignance of contemporary life, thus shedding light upon the nightmares from which we never wake. How might we balance these seemingly incongruous demands? This workshop will examine several techniques, drawn from literature, film, and the courageous efforts of my own students who found safe but healing ways to write discreetly about the most dangerous and delicate parts of their lives.

Art for Life: How our narrative medicine group uses art to bypass the tyranny of linear processes and humanize the medical journey

(Workshop)

Corresponding presenter: David Thoele MD Advocate Children’s Hospital Chicago, IL

Illness is often stressful and challenging for patients, families, and health care providers, accompanied by intense emotions of sadness, self-doubt, blame, shame, guilt and regret. Medical settings are inherently disempowering, often set up to save lives quickly and discharge patients, without consideration of the emotions that often arise when patients and families encounter illness. Systems organized in favor of collaborative journeys toward health can create better outcomes. Creative writing, live music making, and storytelling provide opportunities to optimize emotional wellbeing for patients and health care providers, increase personal power and agency, build resilience, improve care and reduce stress. For the past seven years, members of a multidisciplinary group of doctors, nurses, patients, music therapists, poets, psychologists, Child Life specialists, chaplains, and administrative staff have met monthly, incorporating creative techniques using a narrative medicine approach. Members have grown together as a community and have brought this experience into their professional and personal lives. The outcome has been magical. We completed a study using creative writing in clinical practice, and found this approach significantly lowered stress and fostered communication for patients and health care providers. In this experiential workshop, members of our narrative medicine group will engage you in the structure of our process, using an opening and closing meditation, music, art, close reading, and writing. You will leave this workshop as part of a larger community, and will learn how to start and nurture a similar group in your own setting.

Using Film to Narrate the Non-sighted Experience

(Workshop)

Corresponding presenter: Gloria Hong MD/MHS Candidate, BA Duke University School of Medicine, Harvard University Durham, NC

Among many things, film is a visual medium for storytelling. Nevertheless, it still caters to the enjoyment and service of people who can and cannot see. Our project seeks to empower youths with visual impairments through the exploration of multimedia production centered on health literacy. Previous studies have shown that health education is more effectively delivered through video-based intervention than text-based education in patients with low health literacy. As such, we believe that multimedia production is a unique way to promote health education in our communities. By providing education in health and video production, we equip visually impaired youths with storytelling skills and develop a creative and critical voice in their communities. With the support of mentors in multimedia and medicine, the project lays the groundwork for a group of high school students to envision, direct, and produce their own documentaries to show at the final screening. Upon completion of the program, participants have expressed that they feel more confident about not only themselves but also sharing their narratives among their peers. Although visual media is only one realm in which there is an underrepresentation of the blind population, its potential for wide circulation and media impact is what makes this project unique. Furthermore, the challenge of translating their stories into a visual dimension is an exciting, unprecedented work that can advance the assimilation of the blind individuals into our society.



 
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